What is dissociation a symptom of

Dissociative Disorders

When related psychological abilities fall apart: "being stepped away" as a permanent state

03/07/2017 From Dr. Christine Amrhein

  • Dissociations can be very different: from mild symptoms, which almost everyone has already experienced, to severe disorders.
  • Dissociations often occur after traumatic experiences or severe psychological stress. It is believed that they are a protective mechanism to protect the psyche from unbearable stresses.
  • A number of different disturbance patterns are distinguished. The most common or best known are dissociative amnesia, dissociative fugue, depersonalization and derealization syndrome and dissociative identity disorder (multiple personality disorder).
  • Dissociative disorders are often not recognized or symptoms are mistaken for other disorders. Therefore, a careful diagnosis is very important.
  • Dissociative disorders are usually treated with psychotherapy, which is based on the therapy of post-traumatic stress disorder (trauma therapy). In addition, psychotropic drugs and other methods such as exercise therapy or couple and family therapy can be used.

Almost everyone has already experienced dissociative symptoms: For example, the feeling of "having stepped away" or "standing next to you". This can be the case, for example, if you do something routinely (e.g. driving a car) or if you are very focused on one thing. In normal life, people perceive their thoughts, feelings, sensory impressions, memories and actions as belonging together and as part of their person - but with a dissociation these are as if "separated from each other". Dissociations can take very different forms and vary significantly in their intensity and duration.

More severe dissociative symptoms can occur when someone experiences extreme psychological distress - for example, a car accident or a violent assault. Then it often happens that the person concerned experiences the events as "unreal, like in a dream" or later can no longer remember all the details. Usually the symptoms only last for a short period of time. One speaks of a dissociative disorder only if the symptoms occur very frequently and / or over a long period of time and lead to significant suffering and impairment in important areas of life.

What is a dissociative disorder?

In a dissociative disorder, there is a partial or complete “disintegration” of normally related psychological abilities. This can be sensory perception, memory, consciousness, your own identity or control over body movements. Typical symptoms are, for example, that someone lacks the memory of certain periods of time, that touch is no longer perceived, that body movements are disturbed or that someone loses their identity for a while.

The disorder usually begins in connection with a traumatic or highly stressful event, an insoluble conflict or pronounced interpersonal problems. A key feature of all dissociative disorders is that no organic cause for the symptoms can be proven. Instead, it is assumed that the symptoms are caused by psychological factors - usually extreme psychological stress.

It is also characteristic that the symptoms can vary in severity over time and different symptoms (e.g. memory loss, sensory disturbances) can alternate with one another. At the same time, the symptoms are often aggravated by stressful situations.
In some cases, dissociative disorders also lead to self-damaging behavior. For example, some patients cut or burn themselves in order to return to reality from the dissociative state.